Ask the Docs | Achilles Tendonitis

Patient Question:
Over the past few months, I have been experiencing pain and tightening in the back of my heel/Achilles before and after I play basketball. Last week the pain turned from dull to sharp and now it is painful even at rest. Could this be a strain?

Dr. George Holmes:
Yes, it could be a strain. However, the pain you are experiencing in the back of your ankle (before, after and while attempting to run) could be Achilles tendonitis. This is a condition of degenerative changes rather than just inflammatory changes within the Achilles tendon. These degenerative changes occur as a result of an acceleration of the normal aging process of the Achilles. Activities such as basketball, use of a stair master, running, tennis, and other similar sports overwhelm the normally adequate reparative ability of the Achilles tendon.

Symptoms of pain, swelling as well as decreased strength and flexibility of the Achilles may occur with an increase in pre-established physical activities such as an increase in minutes or intensity on the basketball court. Left untreated, Achilles tendonitis frequently progresses to become a chronically painful condition. In some cases, Achilles tendonitis can lead to a permanent impairment of walking or running.

Dr. Holmes

Treatment Options:
Numerous treatment modalities are available for the treatment of Achilles pain. These may include ice, rest, immobilization, physical therapy, and even surgery. However, the initial treatment specifically for Achilles tendonitis includes night-time splinting, day-time immobilization (Ankle Foot Orthosis, CAM boot or cast), icing, or activity modification. A significant degree of improvement can be observed in about 70% of patients. If these measures fail to relieve pain, the modalities of extra-corporeal shockwave therapy or surgery may be necessary in order for the patient to alleviate the pain and regard function.

Any number of conditions can ultimately be the culprit in causing a pain in or about the Achilles tendon. A brief list includes Achilles tendonitis, Achilles tendinosis, Haglund’s deformity (pump bump), bursitis or tear of the Achilles tendon. The history, physical examination, and review of ancillary tests will allow your orthopaedist to determine the correct diagnosis and treatment plan for your specific condition.

For more information about Dr. Holmes and the Sports Medicine physicians of Midwest Orthopaedics at Rush, call 877.MD BONES or visit them online at www.rushortho.com.

The information contained on this page is intended only for general public education, and is not intended to serve as a substitute for direct medical advice. This information should not replace necessary medical consultations with a qualified orthopaedic physician.

Ask the Docs | More Patient Questions

Frozen Elbow
I read an article about a condition referred to as "frozen shoulder" and was curious if this condition can also affect the elbow. I recently had a problem with my left elbow with similar symptoms that was not a result of any injury and now have an odd formation of scar tissue. For a detailed answer and treatment options, click here now.

Foot Sprain
I twisted my right foot last week in a pickup basketball game. When I walk on it for an extended period of time, it swells to about twice its normal size (on the top of my foot) and begins to hurt to the point that I can barely put weight on it. When I lie down at night the swelling dissipates and by the next morning is almost completely gone. What could this be and should I make an appointment to see a physician? For a detailed answer and treatment options, click here now.

Patellofemoral Pain Syndrome
I have been experiencing pain in my knee and around my kneecap after I play basketball. I also feel this pain during my workday as I sit at my desk. What is causing this? Should I continue to workout or should I taper my activity? For a detailed answer and treatment options, click here now.

Low Back Sprain
I play basketball about three times a week and I have been experiencing pain in my lower back. The pain started last week and back spasms have kept me from my normal activities. It feels better when I rest. How long should I lay off playing? For a detailed answer and treatment options, click here now.

Ankle Sprains
I noticed in recent game reports that a few of the Bulls players have suffered from ankle injuries. This seems to be a common injury with basketball players. How can you tell the severity of a sprain? Do you have any advice for healing and preventing ankle injuries? For a detailed answer and treatment options, click here now.

Hamstring Pull
A few weeks ago I injured my right leg playing basketball. Since then I have been experiencing pain in my hamstring. I'm trying to rest it, and I can ride a bike and walk, but I cannot run or play basketball. I've been doing some strengthening and stretching exercises but it still really hurts to sit or stand up after sitting for a prolonged period of time. Do you have any advice that could help along the healing process? For a detailed answer and treatment options, click here now.

Partial ACL Tears
What is your opinion regarding treatment of partial tears of the ACL? I was diagnosed 6 weeks ago with a 30% tear of the ACL, but no one seems willing to reconstruct it. I am a professional dancer and I need my knee to be 100%–without a brace. I have heard that a partial ACL tear will continue to tear under strenuous activity. Is this true? For a detailed answer and treatment options, click here now.

Bicep Tendon Tear
I am 52 years young and consider myself in good health. Lately, however, I have been experiencing a pain in the deep inner fold where my forearm and bicep meet. It really hurts whenever I do curls or other activities that put additional strain on the area. I would imagine that the pain is possibly associated with a tendon tear. What are your thoughts and what besides not exercising could help ease the pain? For a detailed answer and treatment options, click here now.

Tibial Plateau Fracture
Over the past few months I have been experiencing pain below my left knee while running. After a collision in my basketball game last week, I heard a “pop” and experienced a shooting pain through my knee and down my shin. My knee is now extremely swollen. My family doctor ruled out major ligament damage and has sent me to get X-rays and a MRI. What could this be? For a detailed answer and treatment options, click here now.

Jammed Finger
While playing basketball this week I jammed my finger trying to catch a hot pass. The finger is now tender, swollen, and painful when I bend it. Could this be serious? Should I have X-rays? For a detailed answer and treatment options, click here now.

Hip Pointer
While playing basketball this weekend I collided with another team member and injured my hip. Now my hip is tender and painful when I walk. Could this be serious? For a detailed answer and treatment options, click here now.

Groin Strains
I have been experiencing pain in my inner thigh. There is also some bruising, swelling, and discomfort when I play basketball and push off my right leg. How long do you think I’ll need to rest before it heals? For a detailed answer and treatment options, click here now.

Ankle Sprains
While playing basketball last week I came down wrong on my foot and I think I rolled my ankle. How can I tell if the injury is serious, and when can I return to normal physical activity? For a detailed answer and treatment options, click here now.

Hip Bursitis
While playing basketball last month I fell and landed on my hip. It didn’t seem to hurt much then, but as time has passed I have had an increasing pain at the point of my hip. Is this something that will go away on its own? For a detailed answer and treatment options, click here now.

Plantar Fascia: A Common Basketball Foot Injury
My heel bothers when I play basketball, and it really hurts when I wake up in the morning and stand up after rest. Is this some type of bruise, or is it a more serious injury? For a detailed answer and treatment options, click here now.

Wrist Contusion
While playing basketball this weekend I collided with another team member and injured my wrist on another player’s knee. My wrist is now swollen, black and blue, and tender to the touch. Could this be serious? Should I have X-rays? For a detailed answer and treatment options, click here now.

Mallet Finger
While playing basketball last week I jammed my finger on the ball. My finger is still painful and swollen, but only at the fingertip. I also have trouble straightening the tip of my finger. Do you think anything is broken? For a detailed answer and treatment options, click here now.

Rotator Cuff Tendonitis
When I raise my arms over my head for a rebound or reach to block a shot, I’m having pain in my shoulder. What could be causing this pain? For a detailed answer and treatment options, click here now.

Shin Splints
I’m an active runner and have been experiencing pain in my shins. If I stop training, it goes away but comes back as soon as I resume my running activities. Am I suffering from shin splints? If so, what can I do to treat them other than rest? For a detailed answer and treatment options, click here now.

Piriformis Syndrome
I’m a runner, and lately I’ve been experiencing pain radiating down the back of my leg. It hurts worse when I sit or climb stairs. What is causing this? For a detailed answer and treatment options, click here now.

Iliotibial Band Friction Syndrome (ITBS)
I’m a semi-active cyclist, more of a weekend warrior, really. I have been experiencing sharp burning pain on the outside of my left knee, and even occasionally in both knees. What is causing this pain? For a detailed answer and treatment options, click here now.

Basketball Injuries in the Female Athlete:
I’ve heard that female basketball players are more frequently injured than their male counterparts. Is there any truth in that? For a detailed answer and treatment options, click here now.

Aging and Basketball Injuries:
I’m a 40-something who still enjoys playing competitive basketball. In my advancing years, should I be worried about any increased health risks from playing this demanding sport? For a detailed answer and treatment options, click here now.

Stretching Before Basketball:
I recently pulled my hamstring during a game even though I stretched thoroughly before playing. Some of my teammates rarely stretch and they don’t seem to get hurt. Does stretching really do any good? For a detailed answer and treatment options, click here now.

Torn or Damaged Cartilage:
After I play basketball, my left knee swells considerably. With ice and rest it mostly goes away, but the swelling comes right back when I play again. What causes this? Is there anything I can do about it? For a detailed answer and treatment options, click here now.

ACL Tears:
While playing basketball last week, I felt a “pop” in my knee when planting my foot. I now have a considerable swelling and the knee feels unstable. Do I have ligament damage? For a detailed answer and treatment options, click here now.

Jumper’s Knee:
When I take a jump shot, drive to the basket, or jump to grab a rebound, I often feel a sharp pain behind my kneecap. What causes this? How can it be treated? For a detailed answer and treatment options, click here now.